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Association between pharmacological tenofovir adherence measures and subsequent 24-week viral load outcomes for people with HIV in South Africa

Title: Association between pharmacological tenofovir adherence measures and subsequent 24-week viral load outcomes for people with HIV in South Africa
Authors: Bodley, Nicola; Govender, Katya; Moodley, Pravikrishnen; Samsunder, Natasha; Sookrajh, Yukteshwar; Turner, Philip J; Butler, Christopher C; Hayward, Gail N; Gandhi, Monica; Drain, Paul K.; Garrett, Nigel; Dorward, Jienchi
Source: JAIDS Journal of Acquired Immune Deficiency Syndromes ; ISSN 1525-4135 1944-7884
Publisher Information: Ovid Technologies (Wolters Kluwer Health)
Publication Year: 2026
Description: Background: Objective measures of antiretroviral therapy (ART) adherence, such as tenofovir (TFV) concentrations, may allow for targeted interventions to prevent future HIV viraemia. We evaluated three TFV adherence measures and their association with current and 24-week viral load (VL) outcomes. Methods: In a South Africa-based trial, we measured urine TFV using a point-of-care (POC) antibody-based assay and two metrics assessed via liquid-chromatography-mass-spectrometry: quantitative urine TFV and TFV-diphosphate (TFV-DP) concentrations in dried blood spots (DBS). Logistic regression assessed the association between current and subsequent 24-week VL outcomes and these three measures. We also compared the baseline characteristics of individuals with detectable vs. undetectable POC urine TFV results at enrolment. Results: Of 124 participants, 54.8% female, median age 39 years, 100 (81.5%) had detectable POC urine TFV and 23 (18.5%) did not. Higher TFV-DP concentrations in DBS were negatively associated with viraemia at 24-weeks (OR 0.83, 95% CI 0.725-0.928, p=0.003), whilst a detectable POC urine TFV (OR 0.62, 95% CI 0.22-1.82, p=0.380) and quantitative urine TFV (OR 0.98, 95% CI 0.95-1.00, p=0.153) showed no significant association. Compared to those with detectable POC urine TFV, those with undetectable POC urine TFV were more likely to be viraemic at enrolment (78.3% vs 25.7%, p
Document Type: article in journal/newspaper
Language: English
DOI: 10.1097/qai.0000000000003866
DOI: 10.1097/QAI.0000000000003866
Availability: https://doi.org/10.1097/qai.0000000000003866; https://journals.lww.com/10.1097/QAI.0000000000003866
Rights: http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.26868685
Database: BASE